As reported by the Institute of Medicine, chronic illness care is extremely variable across practices and physicians. Despite the increasing availability of electronic health records and the pressure to adopt quality care standards, healthcare disparities in chronic illness persist. Data across various patient demographics show that disparate care is most likely to be present among high risk individuals, whose care is often complicated by multiple co morbidities. With increasing cost pressures in healthcare delivery, it is very difficult for a clinician to effectively manage such patients during the limited time allowed for a clinical encounter.
Electronic medical records and databases provide important support for the clinical encounter. However, clinical decision-making at the point of care remains a fragmented, labor-intensive and frequently incomplete process. Consequently, a clinician must often rely on his or her memory or constantly interrupt the encounter to seek clarification from multiple reference sources. Such an impractical approach is further exacerbated when encountering complex patients that have multiple co morbidities. Additionally, there is a continuous need to update the clinical knowledge skills of a clinical physician with new evidence. However, as managed care pressures limit the time frame for the clinical encounter, incomplete or inaccurate decision making often results. Therefore, there is a persistent information gap at the point of care that is most detrimental to high risk patients that have multiple co morbidities, as is the case with patients who have cardiovascular disease, diabetes, and asthma. Moreover, cost-benefit analyses for care decisions are generally artificially derived outside of routine chronic illness care delivery. Such analyses may be based on assumptions that may not hold true for high risk individuals with multiple co morbidities. Generating appropriate risk adjustments for such high risk patients is critically important, particularly in the emerging pay-for-performance economic model of healthcare.
Therefore, a heretofore unaddressed need still exists in the art to address the aforementioned deficiencies and inadequacies.